Many people find it very difficult to understand why they are attracted to an individual of the same sex or both sexes when the common perception is that we should only be interested in the opposite sex. This can make it very difficult for them to accept their sexuality, which can lead to loneliness and a sense of isolation and low self-esteem and at its worst depression or even suicidal feelings.

People who are struggling to accept their sexuality or who are finding it difficult to discuss it with others are often worried about whether they will get rejected and stigmatized by the people around them. Factors such as religious beliefs, cultural background or socioeconomic factors may also play a part.

Whilst even today “coming out” is difficult for many people, it was even more difficult in the past. That is why there are many gay men and gay women who got married and are now having to come to terms with their sexuality and what it means. "Coming out" when everyone around you presumed that you were “straight” can have a huge impact on the partner and children. The partner who is not gay might start questioning him or herself. “Did I do something wrong?” “Did I cause this?” or “How long have they been lying to me for?”. For the partner who is gay feelings of guilt may be very strong.

Counselling may help to address these issues in a safe and non-judgmental environment.